Avoidance of healthcare service use and correlates among HIV-positive patients in Vietnam: a cross-sectional study.



The prevention of HIV/AIDS is not making sufficient progress. The slow reduction of HIV/AIDS infections needs to prioritise hesitancy towards service utilisation, including treatment duration, social support and social stigma. This study investigates HIV-positive patients' avoidance of healthcare services and its correlates.


A cross-sectional study.


The secondary data analysis used cross-sectional data from a randomised controlled intervention, examining the effectiveness of HIV-assisted smartphone applications in the treatment of HIV/AIDS patients in the Bach Mai and Ha Dong clinics in Hanoi.


Simple random sampling was used to identify 495 eligible patients. Two-tailed χ2, Mann-Whitney, multivariate logistic and ordered logistic regression models were performed.

Primary and secondary outcome measures

The main study outcome was the patients' healthcare avoidance and frequency of healthcare avoidance. The association of individual characteristics, social and behavioural determinants of HIV patients' usage of health services was also determined based on the collected data using structured questionnaires.


Nearly half of the participants avoid health service use (47.3%), while 30.7% rarely avoid health service use. Duration of antiretroviral therapy and initial CD4 cell count were negatively associated with avoidance of health services and frequency of health service avoidance. Similarly, those with the middle and highest income were more likely to avoid health services compared with those with the lowest income. People having health problems avoided health service use more frequently (OR 1.47, 95% CI 1.35 to 1.61).


Our study's findings identify characteristics of significance in relation to health service avoidance and utilisation among HIV-positive patients. The results highlighted the need to improve satisfaction, adherence and utilisation of treatment. Moreover, identifying ways to address or incorporate those social determinants in new policy may also help the treatment of HIV/AIDS and strategically allocate funding in the changing financial and political climate of Vietnam.

Trial registration number

Thai Clinical Trials Registry TCTR20220928003.





Published Version (Please cite this version)


Publication Info

Nguyen, Huong Lan Thi, Thu Minh Bui, Vu Anh Trong Dam, Tham Thi Nguyen, Hien Thu Nguyen, Ga Mei Zeng, Don Bradley, Quang N Nguyen, et al. (2023). Avoidance of healthcare service use and correlates among HIV-positive patients in Vietnam: a cross-sectional study. BMJ open, 13(12). p. e074005. 10.1136/bmjopen-2023-074005 Retrieved from https://hdl.handle.net/10161/30128.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.



Don W. Bradley

Consulting Professor in the Department of Family Medicine and Community Health

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